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Given the perennial imbalance and chronic scarcity between the demand for and supply of available organs, organ allocation is one of the most critical decisions in the management of organ transplantation networks. Organ allocation systems undergo rapid revisions for the sake of improved outcomes in terms of both equity and medical efficiency. This paper presents a Data Envelopment Analysis (DEA)-based model to evaluate the efficiency of possible patient-organ pairs for kidney allocation in order to enhance the fitness of organ allocation under inherent uncertainty in such problem. Eligible patient-kidney pairs are regarded as decision making units (DMUs) in a Credibility-based Fuzzy Common Weights DEA (CFCWDEA) approach and are ranked based on efficiency scores. Using a common set of weights for all DMUs ensures a high degree of fairness in the assessment and ranking of DMUs. The proposed model is also the first allocation method capable of coping with the vague and intervallic medical and nonmedical allocation factors by the aid of fuzzy programming. Verification and validation of the proposed approach are performed in two steps using a real case study from the Iranian kidney allocation system. First, the superiority of the proposed deterministic model in enhancing allocation outcomes is demonstrated and analyzed. Second, the applicability of the proposed fuzzy DEA method is demonstrated using a series of data realizations for different credibility levels. [ABSTRACT FROM AUTHOR]

Background: The word-in-noise discrimination test evaluates the phonological aspect of speech based on the detection of the vowels. While word-in-noise perception (WINP) test is one of the speech perception exams and evaluates the ability to understand the meaning of words by discovering the consonants. Until now, all word-in-noise tests have assessed speech discrimination performance, and for the first time, the normal values of the WINP test for adults have been determined. Since the normal values of WINP scores in children have not been reported, our research aimed to determine the normal values of the WINP test in children aged 5 to 13 years. In this cross-sectional study, 120 Persian speaking Iranain children with normal hearing thresholds were evaluated from the beginning to the end of spring 2023. We divided them into 4 age groups (A = 5–7 < years, B = 7–9 < years, C = 9–11 < years, D = 11–13 < years). The evaluations included general audiology tests and WINP tests using homtonic-monosyllabic words (HMWs) at a signal-to-noise ratio of 5 dB. Results: Significant difference was observed between the mean scores of the WINP test in age group A (54%) compared to age group B (66%), (Pv = 0.04). Also, the differences between the mean scores of age group A compared to age groups C (70%) and D (69%) were significant (Pv = 0.01, Pv = 0.03). Conclusions: This article presented the norm values of WINP test scores for Persian speaking Iranian children aged 5 to 13 years. The norm values of WINP test scores in the age group of 5–7 years were lower than in the age groups of 7–13 years. The biggest change in the performance of speech perception in noise was observed in the age range of 7–9 years. [ABSTRACT FROM AUTHOR]

Background: We aimed to determine the frequency of mutations in 3 common genes causing neonatal diabetes mellitus (NDM) in Isfahan. Methods: This study was performed on 15 patients with permanent NDM (PNDM). KCNJ11, INS, and ABCC8 gene mutations were examined in all patients. Other related gene mutations were also examined if the first three mentioned mutations were negative. The patients were classified into two groups based on the time of NDM diagnosis (before 6 and 6–12 months of age). Results: Patients with PNDM who were diagnosed before 6 months of age had more concomitant anomalies than those diagnosed between 6 and 19 months of age (p < 0.05). The genetic study did not show any mutation in ABCC8, KCNJ11, and INS genes. Evaluation of other gene mutations indicated that 3 patients (two boys and one girl) had a homozygous mutation in EIF2AK3, one patient (boy) had a homozygous mutation in PTF1A, and also one patient (boy) had a homozygous mutation in GLIS3 gene which are all considered as rare genes which could cause NDM. All of the patients with mutations were diagnosed before 6 months of age. Four out of the five patients were male and had parental consanguinity (2nd and 3rd degree). Conclusion: We found that mutations in KCNJ11, INS, and ABCC8 are not the common cause of PNDM in our population, and mutations in EIF2AK3, PTF1A, and GLIS3 genes are more frequent. The PNDM cases and their related reported mutation were related to the syndromic form of NDM, and all of them were diagnosed before 6 months of age. [ABSTRACT FROM AUTHOR]

Background: Despite the widespread knowledge about social support and health, there is little information about the association between social support and HIV risk behaviors such as condom use among female sex workers (FSWs) in Iran. This study aimed to determine the association between social support and frequency of condom use among FSWs in Tehran, Iran. Methods: Using mixed sampling methods, we recruited 170 FSWs in Tehran in 2017. We measured self-reported social support by face-to-face interviews using a standardized questionnaire. Linear regression was used to assess the association between socio-demographic characteristics (age, education level, marital status, and place of living), transactional sex characteristics (age at first transactional sex and frequency of transactional sex in the last month), HIV knowledge, social support network characteristics (social network size, duration of tie, intimacy, social support), and condom use behavior. Results: Of the total of 1193 persons in FSW's social networks, 615 (51%) were sexual partners, 529 (44%) were peer sex workers, and 36 (5%) were family members. The participants perceived moderate social support from sexual partners, low from peer sex workers, and very low from family members. Adjusted for individual and other network characteristics, peer sex worker social support (b = 0.28, 95%CI 0.06, 0.50), and family support (b = 1.12, 95%CI 0.028, 2.23) were significantly associated with condom use. Conclusion: Family and peer sex worker social support are associated with condom use, but less strongly than HIV knowledge or place of living. However, very few FSWs are socially connected with families. Interventions to promote condom use among this vulnerable population should also consider social and familial support. [ABSTRACT FROM AUTHOR]

Aim: The present research aimed to explore the level of physical activity among the employees of Melli Bank in Tehran in the light of the trans-theoretical model in 2018. Subjects and methods: This cross-sectional study followed a multi-stratified sampling method and selected 612 employees from Melli Bank in Tehran. The data collection instrument was a tripartite questionnaire, the reliability and validity of which was statistically tested and confirmed within this research. SPSS16 was used to statistically analyze the data through independent-samples t-test, one-way ANOVA, correlation coefficient and multiple regressions. The significance level was set at p <.05. Results: In this study, 532 male and 78 female participants were included. Two hundred and ninety-five participants (48.4%) had inadequate physical activity. From among 610 employees, 111 were at the pre-contemplation stage, 164 in contemplation, 160 in preparation, 65 in action, and 110 in maintenance stage. The foremost predictor of performing physical activity was found to be self-efficacy (r =.682, p <.0001). Conclusion: As the results showed, self-efficacy played a major role in the rate of physical activity. To promote self-efficacy among employees, senior management of banks and related organizations such as physical education organization and universities need to support employees. [ABSTRACT FROM AUTHOR]

Appendectomy is accepted as the standard treatment of acute appendicitis, but in complicated cases, the treatment of choice is not straightforward. In this prospective study, we compared failure rate, complications, and recurrence rate of three different approaches to complicated appendicitis. In a 5-year prospective cohort study, patients with appendicular phlegmon were studied in three groups based on the treatment protocols. Group A included patients who underwent an appendectomy; patients of group B were treated by interval appendectomy; and in group C, conservative management was performed without interval appendectomy. Data analysis was performed using SPSS version 11.5. In total, 3896 patients with acute appendicitis were admitted, and 127 patients with complicated appendicitis were treated. Fifty-four patients were excluded from the study. Differences in age, gender, weight, and duration of symptoms were not statistically significant in the three groups. In group A (N = 23), appendectomy was impossible in 4 patients and 5 patients experienced complications. In group B (N = 24), two patients underwent exploration and appendectomy. In another two patients, a recurrent episode of acute appendicitis with mild signs and symptoms occurred after discharge from the hospital. In group C (N = 25), three patients experienced a recurrent appendicitis. Interval appendectomy is not indicated in all patients and continuous non-operative management may be appropriate in some patients. As the epidemiology of colorectal cancer and inflammatory bowel diseases is different in Iran, we recommend other researchers to perform a cost-effectiveness analysis on colon and appendicular neoplasms workup after non-operative management of complicated appendicitis. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to determine effects of community-based healthy lifestyle education on the incidence of metabolic syndrome (MetS) in Tehranian children considering parental factors during a 13-year follow-up.Methods: This study was conducted within the framework of the Tehran Lipid and Glucose Study (TLGS) on 1603 healthy children, aged 8–18 years, who had complete parental data. Parental factors including MetS, education, age, occupation, and smoking were considered to distinguish parental clusters which could potentially predispose children to MetS. Lifestyle interventions were aimed at achieving healthy dietary patterns and increasing physical activity. Cluster analysis and survival Cox model were used to determine potential low and high risk parental clusters and the effect of intervention on the hazard of MetS in children respectively.Results: In a model adjusted for children’s age and sex, the hazard of the MetS incidence was 36% higher in children from high-risk parental cluster than those from low-risk parental cluster (HR = 1.36, 95% CI = 1.07–1.73). Moreover, the intervention group showed a 39% lower risk for MetS incidence (HR = 0.61, 95% CI = 0.44–0.85) compared to controls, during the first 6 years after baseline assessment (short term), although the risk lowering effect of the intervention was not maintained long term.Conclusion: A healthy lifestyle education was successful in reducing the short-term risk of MetS in children. To identify ways of maintaining long-term results, further research is definitely warranted.Trial Registration: This study was funded by National Research Council and Planning and Management Organization and has been reviewed and approved by the Iranian registry of clinical trials (ISRCTN52588395). [ABSTRACT FROM AUTHOR]

Introduction: Clinical guidelines have recommended a 1-year trastuzumab regimen as standard care for early human epidermal growth factor receptor 2 (HER2)-positive breast cancer; however, this recommendation can have a dramatic impact on total drug expenditures in middle-income countries (MICs). We performed a cost-effectiveness analysis from the Iranian healthcare perspective to find an optimum duration of trastuzumab use in Iran.Method: We compared four treatment strategies comprising chemotherapy and varying durations of trastuzumab use (no trastuzumab, 6, 9 months, and 1 year), and a Markov model and probabilistic sensitivity analysis were used to estimate the costs and effects of the strategies. We then examined the cost effectiveness of the strategies at different willingness-to-pay (WTP) thresholds and ages at onset of treatment.Results: Incremental costs (versus no trastuzumab) were €8826 (6 months), €13,808 (9 months) and €18,588 (12 months), while incremental quality-adjusted life-years (QALYs) were 0.65 (6 months), 0.87 (9 months) and 1.14 (12 months). At a threshold of 3 × gross domestic product (GDP)/capita (€21,000/QALY) and for patients younger than 59 years, the 6-month protocol was most likely to be cost effective (probability of 42%). At a threshold of 4 × GDP/capita (€28,000/QALY), the 6-month and 1-year regimens were essentially equal in cost effectiveness (37 and 35%, respectively). At this WTP threshold, the 6-month and 1-year regimens were optimal strategies only for patients up to 66 and 44 years of age, respectively.Conclusion: In contrast to clinical guidelines, 6 months of trastuzumab may be the most cost-effective option for Iran. The lower absolute WTP threshold and lower life expectancy compared with high-income countries are two crucial parameters in the cost effectiveness of interventions in MICs. It is therefore necessary to strike a balance between maximum population health and maintaining affordability in these countries. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to test a conceptual model of associations between socio-demographic and behavioral factors and obesity in the Tehran Lipid and Glucose Study (TLGS). Methods: Data from 2747 TLGS adult participants (58.3 % female) were analyzed. Socio-demographic and behavioral factors in the conceptual model were tested for their direct and indirect associations with overweight and central obesity, using structural equation modeling (SEM), conducted by IBM SPSS AMOS software. Results: Overweight and central obesity were found in 61.6 and 48.1 % of respondents, respectively. Fit indices were acceptable for the conceptual model. Daily energy intake had a direct association with overweight and central obesity in both genders; however, poor dietary pattern had direct associations with overweight and central obesity only in men. In women, age, marital status, and level of education had direct associations with overweight and central obesity. In men, only age and marital status had direct associations with overweight and central obesity. Conclusions: Age and marital status in both genders and level of education only in women were among the socio-demographic factors which were directly associated with both overweight and central obesity. Among behavioral factors, daily energy intake was the most important factor that was directly associated with both overweight and central obesity in both genders. Adherence to poor diet directly was associated with overweight and central obesity only in men. The current findings provide beneficial information for designing culturally relevant and effective interventions/strategies for prevention of overweight among Tehranian adults. [ABSTRACT FROM AUTHOR]

The main aim of this study was to compare fertility in minor (Sunnah) and major (Shia) religious groups of Iran after matching the two groups by some confounding factors. 12,099 data of population and census survey of Iran in 2011 in two provinces of Guilan and Kurdistan were used in this study. Propensity scoring matching method was used for matching two groups. First confounder variables were found and after that the groups were matched. Principal component analysis was used to make a socioeconomic (SES) variable. At the end, two groups were compared to each other by nearest neighborhood method. Also Poisson regression was used to find the effective factors of fertility. Before using matching method, the results showed that fertility in Kurdistan was higher than Guilan, but after matching, fertility in Guilan was higher. The results of regression model showed that in Guilan, living in urban region, age and level of education had effect on fertility, but in Kurdistan, education, age and SES were effective factors. [ABSTRACT FROM AUTHOR]

In this study, knowledge and attitude of Iranian clerical students toward HIV and AIDS was assessed. Through a cross-sectional study, 367 clerical students were surveyed, in convenience sampling method, in the Qom seminary in 2011, utilizing a self-administered structured questionnaire. The questionnaire was piloted on 20 clerical student volunteers, internal consistency measured with Cronbach's alpha was 0.89. Participants' scores of knowledge and attitude were calculated out of 100. The level of knowledge in 37.33 % of participants was good (scores >80), whereas 46.05 and 16.62 % had moderate (40 < scores ≤ 80) and poor (scores ≤40) levels of knowledge, respectively. The mean score of knowledge and attitude was 58.29 (95 % CI 56.11-60) and 77.26 (95 % CI 75.92-78.59) out of 100, respectively. A significant correlation was observed between level of knowledge and attitude ( r = 0.33, P < 0.001). Knowledge score appeared to be significantly higher in women compared to men ( p = 0.04). With an increase in age, the level of knowledge significantly decreased ( r = −0.10, P = 0.02). We could also detect a statistically significant relationship between attending educational courses on HIV/AIDS and inclusion of HIV/AIDS topics in the individual's sermons ( P < 0.001). Although clerical students had shown some sort of positive attitudes toward HIV, their knowledge still needs to be improved to enable them to deliver more accurate information to the community during the course of their speeches. Having HIV-related courses as part of their curriculum or aside may contribute a lot to this. [ABSTRACT FROM AUTHOR]

The psychometric properties of the Persian 'Reading the Mind in the Eyes' test were investigated, so were the predictions from the Empathizing-Systemizing theory of psychological sex differences. Adults aged 16-69 years old (N = 545, female = 51.7 %) completed the test online. The analysis of items showed them to be generally acceptable. Test-retest reliability, as measured by Intra-class correlation coefficient, was 0.735 with a 95 % CI of (0.514, 0.855). The percentage of agreement for each item in the test-retest was satisfactory and the mean difference between test-retest scores was −0.159 (SD = 3.42). However, the internal consistency of Persian version, calculated by Cronbach's alpha (0.371), was poor. Females scored significantly higher than males but academic degree and field of study had no significant effect. [ABSTRACT FROM AUTHOR]